It is the beginning of a new year.  Holidays have past and work is hectic.  The economy is hurting.  Anxiety is in the air.  Suddenly you feel a discomfort in our chest.  Is this the sausage biscuit you had for breakfast?  Is this anxiety over the mounting bills?  Could you be having a heart attack?

Often patients ignore cardiac symptoms or try to explain them away. 

Heart disease is the number one cause of deaths in the United States.  Chest pain or angina is a warning sign that a heart attack is occurring or about to occur.  The chest pain is a result of inadequate blood flow to the heart muscle from a blockage in one or more blood vessels in the heart.  Chest pressure can occur at rest or with exercise.  There may be associated symptoms such as difficulty breathing, nausea, movement of pain to the jaw or arms, and sweating.  Some patients describe indigestion.  They may complain of burning type pain in the chest or upper abdomen with belching and gas.  If these warning signs are ignored the result could be devastating.

Chest pain is one of the most common reasons patients present to the emergency room.  Chest pain doesn’t always signal a heart attack.  There are non-cardiac causes of chest pain.  It is
important to seek medical attention and be evaluated to determine the cause of your symptoms.  Once a cardiac condition has been excluded further evaluation for gastrointestinal problems may be needed.

Heartburn can also cause pain in the chest in the same area as angina or heart pain.  Heartburn is usually worse with meals, lying down or bending over.  Antacids may provide temporary relief.  Like heart pain, there may associated nausea. Indigestion or heartburn is a burning sensation in the upper chest that is caused by acid from the stomach refluxing upward into the esophagus or swallowing tube.

How can your distinguish between the two?  It can be difficult, even for trained professionals.  Anytime chest pain occurs you should see your doctor.  If the pain is lasting more than 15 minutes you should seek immediate care.  Tests can be performed to help determine if the symptoms are cardiac.  Electrocardiograms and blood work are helpful in diagnosing a heart attack.  Once an adequate evaluation of the heart has determined that no heart disease exist, patients my need additional testing of their upper intestinal tract.  Inflammation of the esophagus, stomach or small intestine may be the culprit.  Gallbladder disease can also give similar symptoms. 

If in doubt do not take any chances.  Call or see your doctor for further advice.